Stomach With a Perforated Ulcer

Description

Cut open along its anterior wall, the gaster (ventriculus) is presented with the distal esophagus entering at the cardia and the gastroesophageal junction blending into the gastric mucosa. The fundus and body sweep superiorly and to the left, while the antrum narrows inferiorly toward the pyloric canal, with prominent rugae radiating along the lesser curvature and spreading more widely across the greater curvature. A penetrating ulcer crater interrupts the mucosal folds, extending deep through the gastric wall to create a full-thickness perforation. Perforated gastric ulcer is a surgical emergency because loss of serosal integrity allows gastric contents and acid to spill into the peritoneal cavity, rapidly producing chemical then bacterial peritonitis with rigid abdomen and acute epigastric pain. Location matters: ulcers on the anterior wall more often perforate freely, while those along the lesser curvature risk bleeding from branches of the left gastric artery and may present with hematemesis or melena before perforation. The cutaway format also supports teaching of how ulceration progresses from mucosa into submucosa and muscularis propria, correlating with the sudden onset of pain and the classic finding of free intraperitoneal air on upright chest radiograph or CT. Gastroenterology and general surgery courses can use this artwork to anchor discussions of peptic ulcer disease, H. pylori and NSAID risk, and emergent operative strategies such as omental patch repair and peritoneal lavage. It also fits atlas plates and patient-education handouts that need the stomach’s internal rugae alongside a clear visualization of a perforation. Anatomical accuracy verified by SciePro's Medical Advisory Board.